It has been established that several problems are seriously hampering advancements in the field of human nutrition:
A. Although consumers want to eat healthfully, they are having difficulty understanding nutrition information, comparing and selecting food products and figuring out which nutrition claims are really true. They need a convenient source of information other than manufacturers' advertisements.
B. The United States has been unable to meet its goal of providing routine nutrition education and counseling to the consumer through doctors and other health professionals.
C. Researchers are having difficulty collecting accurate data on the nutritional practices and status of consumers using current nutritional assessment methodologies. These problems are further described below:
A. The Problems of Consumers Making Informed Food Choices:
Today's grocery shoppers still have trouble selecting nutritionally desirable foods. Recent surveys show that consumer knowledge of general nutrition is at peak. However, they are not effectively translating this increased level of awareness into improved dietary habits.
Misleading health claims and advertising, confusing food labels and time constraints while shopping in the supermarket contribute to making brand-name food selections difficult. Studies show that consumers desire to buy food based on sound nutrition recommendations.
Government agencies, the scientific community, industry and consumer groups are striving to develop regulations and education programs to improve the situation. For example, supermarkets have devised shelf-labeling systems to draw attention to nutritionally desirable foods. These attempts, however, usually achieve only marginal success. The Nutrition Labeling and Education Act of 1990 addresses some difficulties consumers face when trying to make informed food choices, such as standardizing the nutrition benefits of foods. However, to make proper selections, consumers will still need to interpret and compare nutrition information from many food items at once, in a busy environment.
B. The Problem of Providing Nutrition Education through Physicians:
In 1980, the U.S. Department of Health and Human Services outlined national health goals to be achieved by 1990. They recommended that doctors and health professionals offer nutrition education and counseling during routine office visits. Doctor's offices are a desirable place to provide nutrition education, but the health-care profession has only partially met this goal. The United States medical system is under severe pressure to continue to improve the quality of medical care, while containing costs. While doctors make dietary recommendations in the treatment of disease, they do not routinely provide preventive counseling. Health-care professionals are unable to provide nutrition education and counseling because it is simply too time-consuming. Though most consumers get their nutrition information from magazines and books, they still consider physicians to be the most reliable source for this information. Therefore, it is logical for doctors to provide nutrition education and counseling during routine health-care visits. However, an effective way to execute this goal is missing.
C. Problems of Current Nutritional Assessment Methodologies:
Although researchers have made correlations between diet and disease on the population level (epidemiologically), it has sometimes been difficult to observe these associations on the individual level. Part of the cause for this are the limited methods used to assess the adequacy of a particular individual's nutritional intake.
Researchers and nutritionists usually measure dietary intake by one of three methods: food diary, diet recall, or diet history. The problem with food diaries is poor compliance. It is simply too hard for subjects to record and describe the consumption of every single food. Accurate diaries require the amounts, methods of cooking and times of consumption for each food. The problem with the diet recall and diet history methods is reporting inaccuracies. For most people it is difficult to remember everything they ate, how it was prepared, et cetera. Not only are studies using these methods expensive and time-consuming, they are subject to error.
There have been prior art devices and methods for generating and retrieving computer stored information pertaining to retail merchandise and food. U.S. Pat. No. 4,780,599 discloses an apparatus for retrieving stored information about various items. While the system disclosed in U.S. Pat. No. 4,780,599 discloses information about food products, it does not provide information pertinent to the individual health and diet needs of individual consumers. Prestored computer software data has similarly been used for tracking inventory, see U.S. Pat. No. 4,180,204, and for obtaining and storing data pertinent to customer demographics. None of these prior art systems have been directed toward the use of a computerized system which can be used to determine and match the nutritional requirements of an individual consumer with particular food items and products.
None of these prior art systems utilize a nutritional database comprised of a comprehensive list of foods and have unique nutrition information specific to each and every food. Typically, many foods such as whole wheat breads are frequently grouped together and considered nutritionally identical in studies, when in fact this may not be the case. Errors of this type are inherent to prior art systems. It would be desirable to provide a computerized system which can match the nutritional requirements and preferences of an individual with specific items of food. It would further be desirable to provide a computerized system for generating and correlating individual data regarding nutritional intake and status.
These and other objectives and desires are achieved through the present invention as set forth in the summary and detailed description which follow.
Dietary factors have been implicated in the etiology of diseases such as coronary heart disease and cancer. The elucidation of such relationships, however, has many times proved difficult. In the case of cancer for instance, preliminary correlations based on the results of human epidemiological and experimental animal studies frequently fail to be verified when studied at the level of the individual. Failure of existing nutritional assessment methodologies to provide sufficiently accurate and precise nutrient intake data have been indicated as one of the causes of this problem.
Estimations of dietary intake data used in epidemiologic studies are generally obtained utilizing food diary, diet recall, or diet history methods. Completion of food diaries on a meal-by-meal basis by study subjects is usually the method to which others are compared. More detailed data are available from food diaries since methods of cooking, portion sizes, and exact ingredients used in mixed foods are obtained. Criticisms of this method include the need for well-informed, compliant study participants, which may introduce a bias and behavior modification by study participants during the self-observation period. Other drawbacks include high data analysis costs, and the significant time and energy required by participants to complete the diaries. The minimum sampling time required to estimate intake of various nutrients using this method varies between one and seven days and depends on the sample population size.
Another widely accepted method of assessing nutrient intake is the diet recall. Here, study participants describe their recent food consumption to a trained interviewer. Popular sampling times for diet recalls include 24 hours and seven days. Diet recalls are subject to error due to inaccurate memories of study subjects. This method is generally used to assess the mean intake of groups rather than the intake of individuals.
The third main form of dietary assessment is the diet history. This method usually consists of study participants filling out food frequency questionnaires or being interviewed to determine food intake frequency over some period in the past. In contrast to recall methods, food histories attempt to assess nutrient intake patterns that have occurred further in the past. Since this method depends on the long-term memory recall by the participant, it is regarded as the least accurate. It has been used to assess the past dietary intake of patients currently suffering from cancer to gain insight about the etiology of their disease.
Variations of these three primary methods also exist. Some of these include personal-, telephone-, and mail-assisted reporting, with retrospective and prospective variations of each. Other methods of assessing dietary intake include the duplicate portion sampling technique and biochemical markers. The duplicate food collection method, where study subjects collect separate aliquots of their food for laboratory analysis, is unpopular due the demand put on study participants in order to comply. It has also been shown to be subject to error. Biochemical markers exist for certain nutrients including ascorbate, carotene, vitamin E, riboflavin, folacin, selenium, cholesterol, fatty acids, and animal protein. These types of assays are not available for most other nutrients and are also subject to limitations and errors of their own.
Most of these methods usually convert food consumption information into nutrient intake data via the coding of various foods for entry into computer programs. This involves assigning foods an alphanumeric code looked up from reference tables. The coding process itself is prone to error, since foods may be categorized differently by different people. This step is also costly and time consuming. Variations in the nutrient databases used to define the nutrient composition of foods pose another problem in assessing data. Database error may be due to the nutrient assay methodology that is used to generate the food composition data. Once nutritional intake data is coded, various existing software programs may be utilized to analyze nutrient intake.
The high degree of variability existing in current nutritional intake methodologies has sometimes produced conflicting results. One of the main causes of this problem is the lack of a "gold standard" method that could be used to assess the validity of the methods that are actually used. Current validations of nutritional assessment methodologies rely heavily on reproducibility and cross reference studies. This leaves a strong need for the further refinement of nutritional assessment methodology. A need also exists for lay individuals to be able to make better assessments of their own nutritional status.
In 1980, the U.S. Department of Health and Human Services published specific goals for 1990 in "Promoting health/preventing disease: Objectives for the nation." The Food and Drug Administration was designated as the lead PHS agency in charge of implementing policies for improved nutrition. The PHS indicated that implementation of these goals would require nationwide public and private support.
Specific nutritional objectives for 1990 included requirements that routine professional health-care visits include nutrition education and counseling. Other objectives included decreases in the population's mean serum cholesterol values and increased awareness concerning dietary factors and disease. Mid-course evaluation of the progress on reaching these goals conducted by PHS indicated that several objectives were unlikely to be reached. The inclusion of nutrition education and counseling in all routine health contacts were among these.
Recent market surveys show that consumer knowledge of nutrition is at a peak. This high level of nutrition awareness, however, is not being used effectively to make improvements in eating behavior. Consumers are confused about which food choices are better for them on a brand-name level. It has been shown that consumers want this information. Government agencies, scientific associations, private industry and consumer groups are all striving to develop programs and regulations to improve this situation.
The Nutrition Labeling and Education Act of 1990 addresses many of the difficulties that consumers face when making informed food purchases. However, it still remains up to the consumer to sift through possible misleading health claims, other advertising influences and complicated food label information to make a wise choice. Additional time constraints compound the problem for the average shopper.